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I. Biochemical Effects and Clinical Response

Robert N. Golden, MD; Matthew V. Rudorfer, MD; Michael A. Sherer, MD; Markku Linnoila, MD, PhD; William Z. Potter, MD, PhD

Arch Gen Psychiatry. 1988;45(2):139-143.

Abstract
• We studied the biochemical effects of bupropion hydrochloride, a unicyclic antidepressant, in 11 depressed patients. Plasma homovanillic acid level increased significantly in patients who had poor responses to treatment but not in patients who obtained good clinical responses. Although bupropion is characterized preclinically as a weak dopamine reuptake inhibitor without appreciable effects on norepinephrine (NE) reuptake, it reduced whole-body NE turnover without altering plasma NE levels at rest and following orthostatic challenge. There was a trend toward a reduction in cerebrospinal fluid 3-methoxy-4-hydroxyphenylglycol and homovanillic acid concentrations following bupropion treatment, although these changes did not achieve statistical significance. Reduction in whole-body NE turnover has now been described for six disparate antidepressant treatments. Poor clinical outcome following treatment with bupropion may be related to perturbations in dopaminergic systems.

Author Affiliations
From the Section on Clinical Pharmacology, Laboratory of Clinical Science, National Institute of Mental Health (Drs Golden, Rudorfer, Sherer, and Potter), and the Laboratory of Clinical Studies, National Institute on Alcohol Abuse and Alcoholism (Dr Linnoila), Bethesda, Md. Dr Golden is now with the University of North Carolina School of Medicine, Chapel Hill.

Footnotes
Accepted for publication Aug 19, 1985.

Read in part at the 138th annual meeting of the American Psychiatric Association, Dallas, May 22, 1985.

Reprint requests to Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC 27514 (Dr Golden).

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